As a new concept, the definition of translational medicine remains obscure. The translational medicine connects the bench to bedside, and its importance would be more remarkable. The development of gastrointestinal surgery reflects the idea of translational medicine. To carry out the translational study, the gastrointestinal surgeon must learn how to find subjects from clinical problems, how to collect complete information and tissues, how to collect complete information and tissues, how to collaborate with others from different fields and how to utilize all kinds of resources. By translational studies, gastrointestinal surgeons may further improve the survival of patients with gastrointestinal tumor.
Gastrointestinal Neoplasms ; Humans ; Translational Medical Research

Humans ; Oncogenes ; Stomach Neoplasms ; genetics

Gastrointestinal Diseases ; physiopathology ; Gastrointestinal Motility ; Humans ; Kinetics ; Postoperative Complications

OBJECTIVE: To investigate the efficacy and related factors of nasal surgery combined with upper air way radiofrequency ablation(RFA) for treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) with chronic nasal blockage. METHOD: One hundred and three mild or moderate OSAHS patients with chronic nasal blockage were recruited, all cases had nasal surgery and upper airway RFA. All patients were evaluated by body mass index (BMI), Epworth sleep scale (ESS), snoring scale, and nocturnal polysomnography (PSG). Eighty-nine patients were reevaluated at least 6 months after surgery with the preoperative methods. RESULT: After operation, the apnea and hypopnea index (AHI) decreased from (18.67 +/- 9.48)/h to (9.22 +/- 7.18)/h; the lowest artery oxygen saturation (LSaO2) increased from (0.83 +/- 0.08) to (0.92 +/- 0.06); the Epworth sleep scale(ESS) decreased from (8.74 +/- 5.67) to (5.12 +/- 3.74); the snoring scale decreased from (7.16 +/- 2.85) to (3.56 +/- 2.26), the percentage of time with oxyhemoglobin saturation below 0.90 (CT90) decreased from (18.64 +/- 12.98) to (10.73 +/- 8.29). All of the differences were obvious (P<0.01). Success was defined as a postoperative apnea-hypopnea in dex < 10 events per hour and at least 50% less than the preoperative value. The surgical success rate was 75.3% (67/89). No major perioperative complications occurred. CONCLUSION Our findings suggest that nasal surgery combined with upper airway RFA can improve snoring and disease-specific quality of life in patients with anatomic na sal obstruction with mild or moderate OSAHS.
Adult ; Catheter Ablation ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; surgery ; Nasal Surgical Procedures ; Sleep Apnea, Obstructive ; surgery ; Snoring ; surgery ; Turbinates ; surgery

Objective To observe the preliminary clinical results and safety of 27-gauge microincision vitrectomy surgery for partial vitreoretinal diseases.Methods A total of 13 patients (13 eyes) who underwent 27-gauge microincision vitrectomy surgery were enrolled.The follow-up period was 6 to 12 months.Preoperative and postoperative visual acuity and intraocular,total operative time,cutting time for removing vitreous,wound healing status,intraoperative and postoperative complications were observed.Results Mean best corrected visual acuity improved from preoperative (1.26±0.66) logMAR (0.10±0.09) to postoperative (0.63±0.52) logMAR (0.35±0.24),and the difference was statistically significant (t=2.743,P=0.018).The difference of mean preoperative intraocular pressure (IOP),IOP of postoperative day 1,day 5,one month and final postoperative visit were not statistically significant (F=0.593,P＞0.05).The mean total operative and cutting times were (36.38±14.97) min and (10.12±3.54) min respectively.Postoperative scleral incision showed linear closure,no cases of postoperative sclerotomyrelated complications such as wound dehiscence,vitreous incarceration and subcoujunctival fluid were observed.No intraoperative and postoperative complications of iatrogenic retinal breaks,endophthalmitis,choroidal detachment,retinal detachment and vitrous hemorrhage were observed.Conclusions The 27-gauge microincision vitrectomy surgery can improve postoperative visual acuity for treatment of vitreoretinal diseases and induce fewer sclerotomyrelated complications,which maybe a safer surgical approach.

OBJECTIVETo explore the effects of chronic hypoxia on left and right ventricular function and the expression of cardiac transient receptor potential canonical (TRPC) channels in rats.

METHODSForty eight SD male rats were randomly divided into control group (CON) and chronic hypoxic pulmonary hypertension model group (CH) (n = 24). In CH group, rats were exposed in chronic hypoxia environment (10% +/- 0.2% O2) to induce myocardial hypertrophy. After 3 weeks, mean systemic arterial pressure (mSAP), right ventricular systolic pressure (RVSP), left ventricular systolic pressure (LVSP), left or right ventricular pressure maximum rate of rise (LV/RV + dp/dt(max)), left or right ventricular pressure maximum rate of descent (LV/RV-dp/dt(max)), right ventricular hypertrophy index (RVMI) and left ventricular hypertrophy index (LVMI) were measured. Left and right ventricular myocardium tissue sections were stained by HE and observed under light microscope. Real-time polymerase chain reaction (real-time-PCR) and Western blot were performed to detect the expression of TRPC subfamily.

RESULTSRVSP, RVMI, RV + dp/dt(max) and RV-dp/dt(max) were markedly elevated in CH group (P < 0.01) in comparison to CON group. LVMI was markedly reduced in CH group in comparison to CON group (P < 0.01). LVSP, LV + dp/dt(max) and LV- dp/dt(max) had no significant changes in CH group in comparison to CON group. Right ventricular myocardial cells of CH group became thick, the nuclei stained deeply, the shape of nuclei became not regularity. Left ventricular myocardial fibers did not change significantly. There was significant difference in the levels of mRNA and protein of TRPC1 between CON and CH groups.

CONCLUSIONFor three weeks exposed to chronic hypoxia induced right ventricular hypertrophy specifically, raised the mRNA and protein expression of TRPC1 on right ventricular myocardial cells . TRPC1 might be involved in the development of cardiac hypertrophy.

Animals ; Disease Models, Animal ; Hypertension, Pulmonary ; metabolism ; physiopathology ; Hypoxia ; metabolism ; physiopathology ; Male ; Rats ; Rats, Sprague-Dawley ; Transient Receptor Potential Channels ; metabolism ; Ventricular Function, Left ; physiology ; Ventricular Function, Right ; physiology

Robotic system helps surgeons in performing surgery. Currently Da Vinci system is the most popular. Da Vinci system has been used for the stomach and bowel diseases in 27 cases(18 cases of stomach and 9 cases of colon and rectum) in the Zhongshan Hospital, Fudan University. Accurate preoperative staging is crucial, and Da Vinci system is advantageous in lymph node dissection, preservation of nerve plexus, and complete resection of mesorectum. Adoption of gastrointestinal tract reconstruction technique should depend on the operation and experience in surgery. Though Da Vinci system has limitations and the cost is high, it is believed to be the future trend.
Digestive System Surgical Procedures ; methods ; Humans ; Robotics ; methods

Objective To study the combination effects of telmisartan and pioglitazone on the expression of heparanases (HPA) and podocin in the kidney of diabetic nephropathy (DN) rats and its possible mechanism. Methods DN model rats were established by intraperitoneal injection with STZ for 12 weeks. All the DN rats were randomly divided into telmisartan group (T group), pioglitazone group (P group), combination of telmisartan and pioglitazone group (L group), and DN group (D group). Healthy rats were chosen as healthy control group(N group). After garage with drugs for 12 weeks, 24-h urinary protein and serum biochemical indicators were examined. RT-PCR and immunohistochemistry methods were applied to detect the mRNA and protein expression of HPA and podocin. Results Compared with T group and P group, 24-h urinary protein of L group was markedly decreased(P<0.05). Compared with the N group, the level of fasting blood glucose, relative renal weight, BUN and Scr in other 4 groups were markedly increased (P<0.05). Compared with T group and P group, the Scr level and the expression of HPA mRNA and protein in L group was markedly decreased (P<0.05), and the protein and mRNA expression of podoein in L group was markedly increased (P<0.05). Conclusion Combination of telmisartan and pioglitazone can down-regulate the mRNA and protein expression of HPA of glomerular basement membrane and up-regulate the protein expression of podocin of podocyte in DN rats, which may ameliorate the proteinuria.

Objective To explore the diagnostic value of contrast-enhanced ultrasonic intravenous imaging and cholangiography in the diagnosis of malignant jaundice obstructive. Methods Forty three patients who were diagnosed with malignant obstructive jaundice by contrast-enhanced computed tomography and contrast-enhanced computed magnetic resonance imaging were enrolled in this study. All of them underwent conventional ultrasound, IV-CEUS and IC-CEUS. According to the results of operation, the diagnosis accuracies were compared among conventional ultrasound, IV-CEUS, IC-CEUS and IV- CEUS combined with IC-CEUS. Results Diagnostic accuracy by the conventional ultrasound , IV-CEUS , IC-CEUS and IV- CEUS combined with IC-CEUS were 72.1%(31/43), 83.7%(36/43), 81.4%(35/43) and 93.0%(40/43), respectively. IV- CEUS combined with IC-CEUS was superior to the conventional ultrasound (P = 0.021). There were no significant differences when the conventional ultrasound was compared with IV-CEUS or IC-CEUS alone (P = 0.194 and 0.307). Conclusions Preoperative evaluation by IV- CEUS combined with IC-CEUS can elaborate the intra-cavitary and extra-cavitary changes of malignant obstructive jaundice. The diagnostic accuracy rate could be effectively improved by IV-CEUS combined with IC-CEUS, which can bring favorable clinical benefit.

Objective To cultivate mice glomerular podocyte with high glucose and high Ang-Ⅱ,observe the morphocytology of podocyte,and investigate protein kinase C (PKC) activity,the expressions of nephrin and CD2-associated protein (CD2AP),and apoptosis of podocyte with injuries cultivations.Methods The conditions immortalization mice podocyte cell lines was cultivated,after passage and differential induce,the cell lines was divided into six groups:normal group,high glucose group,high Ang-Ⅱ] group,the above two mixed group,intervened group of PKC inhibitor,and hypertonic group.After 72 hours,cell apoptosis rate was detected with flow cytometer; PKC activity was detected with enzyme linked immunosorbent assay (ELISA) in 24 hours and 48 hours ; The expressions of nephrin and CD2AP mRNA were detected by real time-polymerase chain reaction (RT-PCR).Results (1)After 24 hours,the PKC of high glucose group and high Ang-Ⅱ group were more activated than normal group [(47.09 ± 1.19) pmol/L,(42.93 ±0.71) pmol/L,P ＜0.05].The activated phenomenon was more obvious in the mixed group.Compared to 24 hours [(58.75 ±0.71) pmol/ L,P ＜ 0.01],PKC was more activated in 48 hours (P ＜ 0.05).(2) Nephrin mRNA was reduced in podocyte exposed to high glucose and high Ang-Ⅱ at least 24 hours (56.87 ± 0.74,48.54 ± 0.86,P ＜ 0.05),and was reduced more in mixed group (11.7 ± 1.54,P ＜ 0.01).(3) CD2AP mRNA was reduced in podocyte exposed to high glucose,high Ang-Ⅱ,and mixed environment at least 48 hours (56.09 ± 1.46,67.68 ±2.58,and 54.08 ±2.74,P ＜0.05).The decrease trend of nephrin and CD2AP mRNA was restrained by PKC inhibitor(90.75 ± 1.33,P ＜0.05).(4) After 48 hours and 72 hours,the apoptosis rates of high glucose group,high Ang-Ⅱ group,and mixed group were risen compared to normal group (P ＜ 0.05).The increase of apoptosis rate can be restrained by PKC inhibitor.Conclusions High glucose,and high Ang-Ⅱ can activate the podocytes PKC activity,inhibit the expression of nephrin and CD2AP mRNAs,and induce podocyte apoptosis.PKC signaling pathway plays an important role in the injury mechanism of Ang-Ⅱ and high glucose to mice podocyte.